SOUTH SUDAN: South Sudan: A Lifeline Under Pressure

Since 2014, the ICRC has evacuated more than 5,000 patients from across South Sudan for life-saving surgery, often aided by South Sudan Red Cross volunteers drawn from the communities they serve. The system that supports them — the aircraft, the medics, the multiple wards — is stretched thin.

Casualties are increasing. Medical facilities are limited. Here is a crisis that draws little

attention beyond its borders. But standing in this department, one of the country’s main trauma referral centres, the imbalance is impossible to ignore.  “The last few months have been very busy, far more so than in previous years. It just keeps getting worse,” says Paul Abraham, the ICRC’s assistant head nurse. He takes a moment between rounds to speak with me, his voice low and steady.

The ward we are in has been operating beyond capacity for weeks, he says. Yet beds must be emptied to make way for tomorrow’s arrivals. The most stable patients will be moved to the overflow tents outside. Ceiling fans churn the smell of disinfectant around the room. 

Heavy rain drums against the roof. Beside us, nurses hoist a young man from the bed onto a gurney and wheel him to the operating theatre.
Infected wounds are common, according to Abraham. In remote areas, insecurity and access constraints can delay evacuations. Phone networks are unreliable. Roads are poor. During the rainy season, some routes become impassable.

Family members sometimes carry wounded relatives for days before reaching a point where evacuation is possible. By then, wounds may be severely infected, and, in the most serious cases, amputation may be necessary.

"Patients might stay for a long time in remote places with no medical facilities. When wounds are exposed to dirt and mud, infection can spread easily. There are no many antibiotics in these places,” he says.